Outcomes and Predictors of Immunotherapy With Targeted Therapies in Anaplastic Thyroid Carcinoma: An Advancing Therapeutic Modality

Tuesday, October 1, 2024

8:06 AM – 8:12 AM EDT

Location: MBCC, 208

Disclosure(s):

Praneet Chandra Kaki, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Robert M. Brody, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Steven B. Cannady, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Anaplastic thyroid cancer (ATC) is the most aggressive subtype of thyroid cancer and is associated with an exceedingly poor prognosis. The role of targeted and immunotherapy in the management of ATCs has been defined and tailored to tumor genetic profile. Due to the nature of this rare disease and heterogeneity of targeted approaches, there have been no large studies assessing changes in outcomes associated with the utilization of immunotherapies.

Methods: Retrospective database study using the National Cancer Database (NCDB). The NCDB was queried for patients diagnosed with ATC from 2015 to 2020. Kaplan-Meier method was used to assess and compare 2-year overall survival (OS) rates among patients receiving different treatment modalities including targeted-therapy (primarily tyrosine kinase inhibitors) and immunotherapy (primarily PD-1 inhibitors). COX multivariate regression was performed to identify treatment modalities as predictors of survival.

Results: Of 1,189 patients diagnosed with ATC during the study period, 76 (6.4%) received immunotherapy and 1,113 did not. Rates of immunotherapy utilization increased each year during the study period from 0.9% in 2015 to 12.3% in 2020 (p < 0.001). Patients who received immunotherapy were, on average, younger than those who did not (65.7 years vs 70.4, p < 0.001). Only 2% of uninsured patients received immunotherapy, compared to 10.1% with private insurance. At 2 years, OS was greatest among patients who received immunotherapy alone (35%) followed by those treated with both targeted-therapy and immunotherapy (29.5%) (p < 0.0001). Patients treated with targeted therapy alone had an OS of 20.6%, and those who did not receive treatment had an OS of 5.97%. On multivariate analysis, undergoing combined targeted therapy and immunotherapy was associated with better survival (HR = 0.60, p = 0.016).

Conclusions: Our national hospital-based results identify predictors of utilization of immunotherapy and targeted therapy, and suggest that immunotherapy combined with targeted-therapy, is associated with better survival outcomes in anaplastic thyroid carcinoma.

Presenting Author(s)

Praneet C. Kaki, BS

Medical Student
Sidney Kimmel Medical College, Thomas Jefferson University
Kendall Park, New Jersey, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

NS

Neel R. Sangal, MD

Resident Physician
University of Pennsylvania Department of Otolaryngology
Phiiladelphia, PA, United States

Disclosure information not submitted.

Senior Author(s)

Robert M. Brody, MD

Assistant Professor
Department of Otorhinolaryngology Head and Neck Surgery, Hospital of the University of Pennsylvania
Philadelphia, PA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

SC

Steven B. Cannady, MD

Associate Professor
Department of Otorhinolaryngology Head and Neck Surgery, Hospital of the University of Pennsylvania
Philadelphia, Pennsylvania, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.